Community care has lost its innocence. Critics and evangelists vie for television space and newspaper headlines. The Chief Medical Officer had to beg for clarification of a term that had developed too many meanings and an “ethos of virtue” (Acheson, 1985). How should it be defined? Can a hospital be part of the community? Does it mean care ‘in’ ‘by’ the community? The Department of Health and Social Security (DHSS) definition seems to be “the provision of alternatives to long-term institutional care for the chronically sick or those suffering from long-term handicaps or disabilities” (Hunt, 1985). Lord Trefgarne (1984) put the policy aim, more simply, as “to move out of hospital those people who do not really need to be there”.
Letter to the President from the Chief Medical Officer, Department of Health
